What syndrome is classically associated with heavy Ascaris lumbricoides infection and what stool finding supports the diagnosis?

• A. Intestinal obstruction with heavy worm burden; stool may show eggs.
• B. Allergic dermatitis with eosinophilia; stool negative for parasites.
• C. Hepatosplenomegaly; stool negative for eggs.
• D. Meningitis with eosinophilia; stool may show larvae

Answer: (A)

Heavy Ascaris lumbricoides infection is classically associated with a mechanical obstruction of the small intestine when there is a large worm burden, particularly in children. The worms can coil together to form a bolus that blocks the lumen, leading to symptoms like abdominal distension, vomiting, and inability to pass stool or gas.

Supportive evidence for this diagnosis comes from stool findings. Fertilized Ascaris females lay eggs that are excreted with the feces, so detecting eggs in the stool strengthens the diagnosis of a heavy intestinal infestation. In very heavy infections, you might even recover adult worms from the stool or vomitus, but the presence of eggs is the classic supportive clue.

Other described scenarios—like dermatitis with eosinophilia, hepatosplenomegaly with negative stool findings, or meningitis with eosinophilia—do not reflect the typical presentation of a heavy intestinal Ascaris infection. Meningitis with eosinophilia is more characteristic of other parasites, and stool findings are not the diagnostic feature there.